The use of containers in medication dispensing machines is well known. Examples of containers used in such automated machines are disclosed in U.S. Pat. Nos. 4,674,652 (Aten); U.S. Pat. No. 4,823,982 (Aten); U.S. Pat. No. 5,213,232 (Kraft); U.S. Pat. No. 5,401,059 (Ferrario); U.S. Pat. No. 5,405,048 (Rogers); U.S. Pat. No. 5,431,299 (Brewer); U.S. Pat. No. 5,502,944 (Kraft); U.S. Pat. No. 5,508,499 (Ferrario) and U.S. Pat. No. 5,522,525 (McLaughlin). Various types of dispensing machines are also known in the medication dispensing art, such as U.S. Pat. Nos. 5,468,110 (McDonald) and 5,593,269 (McDonald), the disclosures of which are incorporated by reference. Many of these containers and dispensing machines are designed for use in hospitals and other healthcare facilities.
A problem with conventional medication containers is integrating them into an automated hospital or healthcare medication distribution and inventory or information system. The problem is further complicated when the system is designed to maintain control over the access to the medication. For example, in a hospital, medication is typically ordered and received by the hospital pharmacy. The pharmacy orders and receives most types of medication from pharmaceutical manufacturers in bulk medication containers containing a large quantity of the medication. The hospital pharmacy maintains control over these bulk containers by limiting the access to them to specific hospital personnel such as licensed pharmacists and their support staff, Entry into the hospital pharmacy is restricted to these personnel.
A distribution problem arises because the hospital pharmacy is located in one part of the hospital while patients are located throughout the many floors and wings of the hospital. The larger the hospital or healthcare facility, the greater the distribution problem becomes. If all medication were kept in the hospital pharmacy, healthcare workers such as nurses and physicians would have to make numerous trips to and from the pharmacy throughout the day to obtain medication for their patients. Because this is impractical, most hospital medication distribution systems include a variety of sites or rooms for storing and dispensing medication throughout the hospital. For example, the intensive care unit requires a small quantity of a wide variety of medications to be stored in its medication dispensing room. In emergency situations, there is no time to walk to the other end of the hospital and negotiate the stairwells and elevators to obtain a specific medication.
Maintaining adequate inventories of hundreds or thousands of medications, tracking the flow of these medication through a hospital or healthcare facility, controlling the access to the powerful and expensive medications kept at the dispensing sites, and organizing and storing these medications so that they can be easily identified and obtained during normal and emergency situations is no easy task. The more control over the access to the medication, the more cumbersome it is for the healthcare workers to efficiently perform their jobs and administer the prescribed medications to their patients. To facilitate the ease and efficiency of performing their jobs, healthcare workers are frequently allowed easy access to many medications kept in their area of the hospital. This efficiency comes at a price. The ease of access to the medication compromises the pharmacy's control over the medication distribution and inventory system. The pharmacy has a difficult time identifying which medications are running low. In addition, medication is more easily misplaced, lost or stolen by healthcare workers, patients, hospital staff and visitors. This situation becomes more problematic each year as more and more powerful and expensive drugs are introduced into hospital medication distribution and inventory systems.
To improve control over the medication distribution and inventory system, many hospitals are using automated or semi-automated medication dispensing machines at various medication distribution sites throughout the hospital. The dispensing machines usually include a computer processor and keyboard for communicating with the machine. These automated dispensing machines are often designed to improve control over the medication kept inside them by requiring healthcare workers to identify themselves or a specific patient before the machines will dispense a dose of medication. The machines frequently contain several smaller medication containers or cassettes that each hold a specific type of medication. The cassettes may be removed from the dispensing machine to fill with a desired type and quantity of medication, but may be locked or otherwise stored inside the dispensing machine during use.
Several problems remain in conventional medication distribution and inventory systems using automated medication dispensing machines. One problem is that the dispensing machine cassettes do not keep track of the quantity of medication doses they contain. The cassettes are not designed to keep track of the type and amount of medication they contain during use, and do not communicate this information to the dispensing machine. In order to tell how much medication is left in a particular container it is frequently necessary to open it up and count the doses it contains. Systems that require healthcare workers to open the cassettes on the hospital floor can be cumbersome to use and diminish the control over the access to the medication outside of the pharmacy.
These systems also suffer from the problem that it is difficult for healthcare workers to tell when the dispensing machines are running out of a specific type of medication. If improved access control is desired, the dispensing machines have to be locked. One of the pharmacy staff has to do rounds on a regular basis to ensure the dispensing machines are properly stocked and to add additional doses of medication to the cassettes when needed. This is a time consuming and monotonous job that is prone to mistakes.
Another problem with automated dispensing machines is that in order to maintain control over the access to medication, the pharmacy staff is burdened with the task of inserting the cassette into the dispensing machine and manually entering medication quantity information into the machine. Again, this data entry process is a time consuming and monotonous job that is prone to mistakes that prevent accurate tracking of medication in the distribution and inventory system. In addition, pharmacy personnel are frequently performing other jobs that prevent them from refilling the cassettes and delivering them to the necessary distribution machines when needed.
Another problem is that the cassettes are not able to communicate with the bulk containers in the hospital pharmacy. When an unused quantity of medication is taken from the cassettes and returned to the bulk containers, the doses of medication must be counted by the pharmacy staff before adding them back to the bulk container. The bulk container must then be updated to reflect the appropriate increase in medication in the bulk container. This is yet another monotonous task that is prone to mistakes that render the medication inventory system unreliable. In addition, no mechanism is provided to ensure that the pharmacy staff returns the medication to the proper bulk container.
A similar problem arises when a patient is prescribed a special type of medication that is kept in only one or two of the various medication dispensing machines. When the patient is moved from one area of the hospital to another, such as from intensive care to surgery, the cassette containing the special medication must be removed from one dispensing machine and placed in another located closer to the patient. Unfortunately, conventional dispensing machines and cassettes are not provided with a mechanism for communicating updated quantity information when a cassette is transferred from one dispensing machine to another. Instead, a healthcare worker or one of the pharmacy personnel must count the number of doses remaining in the cassette to ensure there is an adequate amount remaining before loading the cassette in the other dispensing machine and manually entering this quantity information in new dispensing machine.
Another problem with conventional medication cassettes is that they are not capable of easily facilitating a pharmaceutical manufacturer recall of a specific batch of medication. Once medication is dispensed from a bulk medication container, the pharmacist has difficulty locating, identifying and gathering up the medication should the manufacturer recall the batch of medication. A similar problem occurs for medication that has a predetermined shelf life. Once the shelf life has been exceeded, the pharmacist has difficulty locating, identifying and gathering up the expired medication.
Another problem with conventional medication cassettes is that they are not designed to help maintain control over the access to the medication in the cassette after it leaves the pharmacy or is inserted into a dispensing machine. Many conventional cassettes are not sealed to prevent access to the medication inside. Other conventional cassettes are sealed but not locked shut. This creates an undesirable situation given the powerful nature of many new drugs and the cost of these drugs.
Another problem with conventional dispensing machine cassettes is that they do not keep track of the physician that prescribed the medication, the health care worker that dispensed the medication or the patient for whom the medication was dispensed. When the pharmacist pulls the cassette from the dispensing machine or the cassette is returned to the hospital pharmacy, the cassette does not contain information about the prescribing physician, the administering healthcare worker or the patient that was given the medication. This information is often desirable to the pharmacist as a double check to ensure that the medication was given to the correct patient by an authorized healthcare worker.
Another problem with conventional dispensing machine cassettes is that they are not designed to be readily integrated into a comprehensive distribution and inventory database system. The hospital staff must determine the type and quality of medication in each cassette for every dispensing machine located throughout the hospital. This information must then be added to the pharmacy data base to obtain a comprehensive inventory for the hospital.
The present invention helps overcome these and other limitations in cassettes used in conventional hospital medication distribution and inventory systems.